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'Mini-med' plan waiver application deadline set


WASHINGTON—Federal regulators say they will stop accepting applications after Sept. 22 from sponsors of limited health care or “mini-med” plans for waivers from a health reform law requirement that plans must offer minimum dollar coverage amounts for essential benefits each year.

In addition, plan sponsors that already have received waivers—including those whose waivers have not yet expired—have until Sept. 22 to seek an extension, the Department of Health and Human Services announced Friday.

Time extended

The waivers now will last through the end of 2013 if sponsors comply with certain requirements, including submitting information about their plans to the government each year and ensuring that enrollees understand the limits of the coverage. Previously, waivers lasted only one year.

Steve Larsen, director of HHS' Center for Consumer Information and Insurance Oversight, which is handling the waivers, said at a Washington briefing that plans that needed waivers from the annual limit requirements most likely would have received the waivers by now.

At the end of May, 1,433 waivers had been approved, including 62 new waivers. In all, 3.2 million people are in plans that have received waivers, HHS said.

The waivers are needed because most, if not all, mini-med plans run afoul of federal rules—mandated by the health care reform law—that set a minimum annual dollar limit on essential benefits that health care plans must provide. The minimum limit is $750,000 in 2011, $1.25 million in 2012 and $2 million in 2013.

Starting in 2014, the law bars annual limits for essential benefits.

Waivers are allowed if sponsors can prove that meeting the annual limit requirements would result in significant increases in premiums or significant decreases in access to health care benefits.

Majority of waiver requests approved

In all, about 95% of waiver requests have been approved, HHS said.

In a report issued earlier this week, the Government Accountability Office found that most approved plans had projected premium increases of at least 10% to meet the annual limit requirement, while those denied waivers typically projected premium increases of 6% or less.

Some Republican health care reform law critics have charged that political favoritism played a role in who got waivers, but the GAO said regulators used objective standards in acting on waiver requests.

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